Mark Bulstrode
BBC News

We've just passed handover time from the night shift into the day shift here at Ipswich Hospital's emergency department.

I went along to a "five topics" meeting where the different staff teams get together and share information about what's going on around the hospital, feedback they've had and things to watch out for.

We'll be doing our own live page handover shortly, and our colleagues Laurence and Richard will be taking over things for the daytime shift.

If you've got thoughts on anything you've seen on our page this morning, you can tweet us using the hashtag #AandElive.

Jodie Halford
BBC News

The chief executive of Ipswich Hospital, Nick Hulme, says the NHS needs to be "rebalanced and restructured" to better fit the change in demographics since the service was created in the 1940s.

"People are living longer but not neccessarily having healthy lives. There are many people living with long-term health conditions, and there's an issue with people getting access to primary care services like GPs," he said.

"A&E is the only place the lights are always on, but we need to have real, strategic, systematic change to keep delivering the best service we can."

I've just had the pleasure of meeting 90-year-old Olive Davies from Ipswich, who has been in A&E for about an hour.

She was brought in after waking up at 05:00 with chest pains - her husband was really worried and called 999, and the ambulance turned up "within five minutes".

It's not her first visit with chest pains - she's suffered from them before, and had a double bypass in 2003. "I was a very fit young lady," she tells me. "In the Army for years. My heart issues haven't stopped me from doing things."

And she is full of praise for the team treating her this morning: "It's one of the best hospitals I know. They don't just come and ask if I'm alright and go away again - they check, and really make sure. They look after me," she said.

Jodie Halford
BBC News

Ipswich Hospital Chief Executive Nick Hulme arrived at work bright and early this morning and has been speaking to me about the four-hour emergency department waiting target - something he describes as a "promise".

"Four hours is a very long time, but in that time we need to treat people who come to A&E as quickly and safely as possible. We need to give them their lives back.

"I've been at inquests into the deaths of patients at other hospitals I've worked at, and on both occasions the deaths were entirely down to those patients not being seen quickly enough.

"Our aim here is to give people the highest quality and safest care within four hours. It’s not an either or. But we can only deliver the promise to patients if the system works well."

Jodie Halford
BBC News

If you're just joining our A&E live page - welcome. We've been at Ipswich Hospital since midnight, reporting on all the goings-on from the emergency department here.

You can scroll back down the page to read all our updates so far and catch up with the patients and staff we've been speaking to.

It's getting light outside and the hospital is gearing up for a busy morning. A few staff members I've spoken to told me things usually start to pick up from now onwards, and can often stay that way until the late evening.

Jodie Halford
BBC News

Earlier on, we spoke to Philip Gardner, whose younger brother Owen had been brought to A&E after collapsing during a night out.

We've been to catch up with the pair - they've now been at the hospital for five and a half hours, and Owen has been having check-ups to monitor his injuries.

"I've collapsed like this before, but this time it's worse than before - I've cut my chin and bashed my teeth," he told me.

"After spending the night here, I'm knackered. I'll be having another check this morning and then hopefully home to bed."

Jodie Halford
BBC News

Debbie Hasleton has been working on reception at A&E for the last year.

"You get everything and anything coming through the doors," she says, "from chest pains to broken limbs to stubbed toes. We treat everyone the same no matter what the condition."

Until a few minutes ago, she had a sign on her desk telling A&E patients to expect a wait of four hours.

"People don't like the sign but at least they're being warned. It's their choice to stay if they want. People might be here two or three hours and then decide to leave.

"When people get angry or aggressive, all you can do is explain. We do have co-ordinators and security staff we can call if things get out of hand, but it all depends on how the person is presenting."

Healthcare assistants like Hayley Carter focus on keeping the patients fed and watered, as well as dressing their wounds, reassuring their relatives and passing on observations about their condition to doctors. 

"On an average night in A&E, we can see anything from sepsis to overdoses, cardiac arrests to falls," Ms Carter told me.

"I think waiting times are getting worse - people come here who don't need to be here and won't wait for a GP appointment, or can't get one."

Jodie Halford
BBC News

Another of the patients here tonight, 18-year-old Caitlin Webb, from Ipswich, has come in with abdominal pain.

She says the A&E unit has "been a bit busy" while she's been here, but that "they treat you with respect and care".

However, she says she believes patients who "aren't life-threateningly ill" can be "left for a while".

"I'm aware there's a four-hour wait time, and as soon as you get to the breach time, they treat you," she added.

Jodie Halford
BBC News

We've been bringing your our live page from Ipswich Hospital for about four hours now, and this is the current scene in the A&E waiting room.

There's just a handful of patients in this area, with more in another section of the department who are waiting to see a doctor or get further treatment.

Staff have told me things tend to ramp up around 06:00, but it seems like we're in the calmest part of the night at the moment.

Jodie Halford
BBC News

Nicola Seston, 29, a carer from Woodbridge, has been waiting in A&E for three and a half hours.

She started having chest pains at 23:00, and phoned the 111 service who called an ambulance for her. 

"The first responder got there in five minutes, and the ambulance itself within 10," she said.

"They've taken bloods and done an ECG, and now I'm just sitting and waiting. 

"When I got here and saw everyone in the waiting room, I knew we'd be in for a long wait. But I hadn't expected to come in on a Wednesday night and for it to be like that."

• 385,000 people live in the hospital's catchment area
• 45-acre site on the eastern side of Ipswich
• 3,000 people are looked after each day by the hospital
• 4,075 employees
• £230m annual budget

Jodie Halford
BBC News

Ann Withey, 65, whose husband Paul was brought in with chest pains earlier, says A&E is much less busy now than the last time she came in.

She was here a few weeks ago with her 97-year-old mother who had stomach pains, and the wait time was much longer.

"All the bays were full when we were here last time so my mum was put in a queue. We were a long time in A&E - too long for her age, I thought.

"When Paul told me about the chest pains earlier, I called the ambulance and the operator stayed on the phone with me the whole time - it felt like I had someone there with me. I'd say we only waited about 15 minutes and he's been seen to and treated very quickly now we're here."

Jodie Halford
BBC News

Paul Withey, 70, was brought into A&E in an ambulance earlier on. He'd woken up with severe chest pains just before 01:00 and his wife Ann had called 999 after not being able to get through to the 111 service.

"The chaps came fairly quickly and used a magic spray under my tongue, so I'm feeling quite comfortable now. I'm just glad I'm in the right place," Mr Withey said.

Student paramedic Adam Hounslea was part of the crew called to Mr Withey's house in Copdock.

"I'm on a 12-hour shift which started at 19:45 and this gentleman was our second patient of the night," he said. "We've been pretty busy. With Mr Withey, we had to wait for backup as we were in an ambulance car, but we've now handed the patient over into the care of the nurses."

Jodie Halford
BBC News

Martin Woods, 38, from Hadleigh, arrived in A&E at about midnight. He's with five other patients waiting to be seen.

Martin broke his finger a few days ago while using weights at home, and was putting up with the pain. But when he arrived at work at the Port of Felixstowe earlier, he found he couldn't drive his vehicle, and was sent to hospital to get checked out.

"There was a sign on reception that said there was a four-hour waiting time," Mr Woods said. "I've been here two and half hours so far. When I came here I was prepared for a long wait, probably all night - I'd been geared up for working all night so it's no trouble."

We're in the accident and emergency department at Ipswich Hospital, which is part of the Garrett Anderson Centre. 

Elizabeth Garrett Anderson (1836 – 1917) was the first female doctor in England and a pioneer of medical education for women.

After her medical career Elizabeth moved to Aldeburgh, Suffolk, where she became the town’s mayor.

Jodie Halford
BBC News

In the staff room, some of those who are halfway through their 12-hour shifts are taking their breaks.

Heathcare assistant Hayley Carter (who has brought a chocolate Swiss roll for staff to share) has worked at Ipswich Hospital for 14 years - five of those in A&E.

"Tonight's calmer than average - nights like this are quite rare," she said. "They only happen once or twice a month.

"We always say if we have a quiet shift one night, it'll be busy the next. And full moons make all the difference - it's always busier during a full moon, which we've just had."

Josh Rush (pictured left) has worked as a technician, or porter, for two-and-a-half years. His role involved pushing beds to wards elsewhere in the hospital and taking patients for x-rays or CT scans.

"There's two of us on the night shift. I started at 19:45 so I'm about halfway through my shift," he said.

"Tonight's pretty settled, but it could get busier - you never know what's going to happen."

Jodie Halford
BBC News

Andrew Durrell, a friend of Tony Tottle who was with him when he fell on the platform at Ipswich station, said they'd waited 20 minutes for an ambulance to come and had called twice.

"You don't know what else is going on, so the wait was understandable. But once the paramedics turned up they were so caring, and that's what's important.

He said once they reached the hospital, staff had explained everything as they treated Mr Tottle and "nothing had been too much trouble".

"Every bit of communication has been so caring and effective. Our experience of the NHS couldn't have been better," Mr Durrell said.

Jodie Halford
BBC News

Tony Tottle is in one of the bays in the "majors" area of Ipswich Hospital's A&E - he was brought here by ambulance after falling from a train at Ipswich station.

The 74-year-old, who lives near Woodbridge, had been at a Freemasons' meeting in London for the day before the fall happened.

"I was brought straight into this bay and was bandaged up and checked over. There's been lots of explanation of what's been going on - the staff have treated me like a sentient and sensible person, and I can't fault them on that.

"I've been looked after with kindness, generosity, good humour, and professionalism that's far from being cold - in fact everyone has been warm, friendly and humorous."

Jodie Halford
BBC News

Charge nurse Alex Scott says in the 25 years he's worked here, he's seen a definite change in the number of people having to wait for longer to be treated when they come to A&E.

"The four-hour target waiting time has two aspects to it," he said. "People want to be seen, treated, and to go home within a reasonable period of time. But the other aspect is that it's a finite resource - I've only got 10 stretcher bays and when they're full, they're full.

"The quicker we see people, the quicker you can put someone else in that stretcher bay. But when they're all full, we have to put people on stretchers in the corridors."

When I asked how often they had to do that, Mr Scott replied: "Every day", before adding that had not been the case when he started working here, and had become much more common over the years.